Name and Address of PETITIONER or ATTORNEY Telephone No.: FOR COURT USE ONLY PETITIONER IN PROPRIA PERSONA: (Yes/No) SUPERIOR COURT OF CALIFORNIA, COUNTY OF SAN BERNARDINO 351 North Arrowhead Avenue, San Bernardino, CA 92415-0210 8303 Haven Avenue, Rancho Cucamonga, CA 91730 14455 Civic Drive, Victorville, CA 92392 235 East Mountain View, Barstow, CA 92311 6527 White Feather Road, Star Route 1, Box 60, Joshua Tree, CA 92252 In the Matter of the Petition of: Adopting Parent(s) CASE NUMBER: AGREEMENT OF ADOPTION OF ADULT (Adopting Person) , an adult person residing at (Street Address) in (City), California, being desirous of assuming toward each other the legal relation of parent and child, and of having all of the rights and being subject to all of the duties and responsibilities of that relation, do hereby mutually agree that (Adopting Person) shall adopt (Proposed Adoptee) . IT IS FURTHER AGREED by the parties that they will petition the Superior Court of California, County of San Bernardino for a decree approving the agreement and declaring that (New Name) is the child of (Adopting Person) . IN WITNESS WHEREOF, we have hereunto set our hands this . day of , Petitioner Petitioner ACIS Code 37455(01) AGREEMENT OF ADOPTION OF ADULT Attachment1 Petition for Adoption (Adult) SB-37455 2002 © American LegalNet, Inc.